慢性牙周炎的中医药治疗研究进展

李瑛琦　张煜培　王晨茜　翟佳雪　唐成芳　曾辉

[摘要]慢性牙周炎是一种常见的口腔疾病，是由菌斑微生物侵袭与宿主防御反应间的动态平衡被打破引起的慢性感染性疾病。目前，临床上通常采用洁治、刮治、根面平整术等牙周基础治疗配合西药治疗，虽然西药具有一定疗效，但存在耐药性、易发不良反应等缺点。近年来，在中医中药治疗慢性牙周炎方面展开许多临床及实验研究，疗效确切。本文就病因病机、临床研究及实验研究三个方面对中医药治疗慢性牙周炎的研究进展进行综述。

[关键词]中医中药;慢性牙周炎;病因病机;临床研究;研究进展

[中图分类号]R78    [文献标志码]A    [文章编号]1008-6455（2021）10-0178-04

Research Progress of Chronic Periodontitis in Traditional Chinese Medicine

LI Ying-qi，ZHANG Yu-pei，WANG Chen-qian，ZHAI Jia-xue，TANG Cheng-fang，ZENG Hui

（Department of Stomatology，Xian Medical University，Xian 710021，Shaanxi，China）

Abstract： Chronic periodontitis is a common disease of oral cavity， which is caused by many kinds of factors of chronic progressive disease. For the treatment of periodontal disease， the main emphasis of previous clinical treatment is periodontal non-surgical treatment， such as supragigival scaling， subgingival scaling， root planning and so on， cooperating with western medicine. Although western medicine has some therapeutic effects， but it also has the potential of drug resistance. In recent years， a lot of clinical studies and experimental studies have been carried out on the treatment of chronic periodontitis with definite curative efficacy. This paper reviews the recent research progress in etiology， pathogenesis， clinical research and experimental research.

Key words： Chinese Traditional Medicine; chronic periodontitis; etiology and pathogenesis;clinical research;experimental study;research progress

慢性牙周炎是由于牙菌斑中微生物病原体与宿主免疫系统间的平衡被打破，并在此基础上形成了复杂的炎症级联作用，而导致牙周组织破坏。临床上主要表现为龈沟液量增加、牙龈出血、进行性附着丧失、牙周袋形成及牙槽骨吸收，最终导致牙齿松动脱落等，是成年人牙齿丧失的首要原因，严重影响患者的日常生活质量。菌斑微生物是牙周炎发病的始动因子，牙周健康时，龈沟中多为需氧菌或兼性厌氧菌;牙周炎时厌氧菌比例增高，牙周致病菌主要包括牙龈卟啉单胞菌、伴放线聚集杆菌及福赛坦氏菌等[1]。这些细菌可通过激发宿主的免疫反应，释放大量炎症介质，从而导致牙周支持组织破坏[2-3]。此外，慢性牙周炎可伴发牙周牙髓联合病变、牙周脓肿等而产生局部疼痛及全身不适反应。……